Ligation of the superior vena cava for recurrent pulmonary emboli.

A patient with polycythemia vera developed chronic thrombosis of the superior vena cava and had life-threatening pulmonary emboli despite anticoagulation and chemotherapy for the blood dyscrasia. After angiographic evaluation, the superior vena cava was ligated cephalad to the azygous vein. There have been no further clinical embolic episodes nor adverse effects over a three-year period of observation.